NPIMap

Individual provider Active NPI

Andrzej R Maciejewski, MD

  • Nephrology Physician
  • Anchorage, AK
National Provider Identifier
1194780114
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4655 Issued in AK
Practice address
3300 Providence Dr Ste 309
Anchorage, AK 99508-4621
Phone
(907) 222-1714
Fax
(907) 222-1724
NPI assigned
Apr 20, 2006
Last updated
Mar 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 1004693 AK
Nephrology Physician 207RN0300X 4655 AK Primary

Addresses

Primary practice location

3300 Providence Dr Ste 309
Anchorage, AK 99508-4621

Mailing address

3300 Providence Dr Ste 309
Anchorage, AK 99508-4621
Phone (907) 222-1714

Other practice location 1

16839 Park Place St
Eagle River, AK 99577-7819
Phone (907) 694-3303

Other identifiers 2

IdentifierTypeStateIssuer
P00117806OtherRAILROAD MEDICARE
MD2805MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091112000420 AK Practitioner - Internal MedicinePractitioner - Nephrology 5496809444 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Suite 150
Eagle River, AK 99577-8078
Phone (907) 694-8085

16839 Park Place St
Eagle River, AK 99577-7819

3260 Providence Dr
Suite 523
Anchorage, AK 99508-4608

3300 Providence Dr
Suite 309
Anchorage, AK 99508-4621
Phone (907) 222-1714

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
20.76 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
69.19

Merit-based Incentive Payment System (MIPS)

Final score
70.59 of 100Reported as group
Quality
83.37
Promoting interoperability
100
Improvement activities
40
Cost
16.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions228
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1004693AKMDDermatology Physician
4655AKMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle River Dermatology Inc Dermatology CurrentSince Nov 17, 2018 Accepting new patients
Andrzej Maciejewski MD, Inc Nephrology CurrentSince Nov 12, 2017 Accepting new patients

Locations

3260 Providence Dr
Ste 523
Anchorage, AK 99508
Phone (907) 222-1714

3260 Providence Dr
Ste 526
Anchorage, AK 99508
Phone (907) 222-1714

3300 Providence Dr
Ste 309
Anchorage, AK 99508
Phone (907) 222-6240

16839 Park Place St
Eagle River, AK 99577
Phone (907) 694-3303

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1194780114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 PROVIDENCE DR STE 309",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084621",
            "telephone_number": "907-222-1714",
            "fax_number": "907-222-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 PROVIDENCE DR STE 309",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084621",
            "telephone_number": "907-222-1714",
            "fax_number": "907-222-1724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16839 Park Place St",
            "address_purpose": "LOCATION",
            "city": "Eagle River",
            "state": "AK",
            "postal_code": "995777819",
            "country_code": "US",
            "telephone_number": "907-694-3303",
            "fax_number": "907-694-4773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACIEJEWSKI",
        "first_name": "ANDRZEJ",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AK",
            "license": "1004693",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AK",
            "license": "4655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00117806",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD2805",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.